Board of Dental Examiners Changes to Application Process: PBIS Closure Due to the closure of Professional Background Information Services (PBIS) as of November 16, 2020, all items that would normally be submitted through PBIS must now be submitted directly to the division. Please see the appropriate checklist for the application with which you are submitting: Application Checklists. Please contact the licensing examiner with any questions: boardofdentalexaminers@alaska.gov INITIAL Applications Dentist Applications Application for Dental Licensing by Credentials #08-4159, Revised 04/01/18 Application for Dental License by Examination Level II #08-0074, Revised 11/28/18 Application for Dental License by Examination Level III #08-4165, Revised 11/28/18 Application for Permit to Administer Moderate Sedation #08-4172, Revised 12/12/18 Application for Permit to Administer Deep Sedation or General Anesthesia #08-4618, Revised 04/01/18 Application for a Courtesy License to Practice Dentistry or Dental Hygiene #08-0005, Revised 12/19/13 Notification of Sedation Agreement #08-4749, Revised 04/01/18 Application for Temporary Permit #08-4789, Revised 03/08/19 Hygienist Applications Application for Dental Hygiene License by Credentials #08-0075, Revised 06/20/19 Application for Alaska Dental Hygiene License by Examination Level II #08-4605, Revised 06/20/19 Application for Alaska Dental Hygiene License by Examination Level III #08-4166, Revised 06/20/19 Application for Certificate to Administer Local Anesthetic Agent #08-0073, Revised 04/01/18 Dental Hygiene Restorative Function Endorsement Application #08-4567, Revised 01/13/17 Dental Hygiene Collaborative Agreement Application #08-4542, Revised 05/10/2013 Application for a Courtesy License to Practice Dentistry or Dental Hygiene #08-0005, Revised 12/19/13 Dental Hygiene Nitrous Oxide Certificate Application #08-4748, Revised 03/21/18 Dental Assistant Applications Application for Certification to Perform Coronal Polishing #08-4561, Revised 01/30/15 Application for Certification to Perform Restorative Functions #08-4577, Revised 01/30/15 RENEWAL Applications Biennial Dental License Renewal #08-4132, Revised 12/20/20 Biennial Dental Hygiene License Renewal #08-4063, Revised 12/20/20 Dental Hygiene Restorative Function Biennial Certificate Renewal #08-4609, Revised 12/20/20 Dental Assistant Coronal Polishing Biennial Certificate Renewal #08-4610, Revised 12/20/20 Moderate Sedation Permit Renewal #08-4780, Revised 12/20/20 Deep Sedation and General Anesthesia Permit Renewal #08-4781, Revised 12/20/20 Dental Assistant Restorative Function Certificate Renewal #08-4784, Revised 12/20/20 Radiological Equipment Applications Radiological Equipment Registration Form #08-4420, Revised 02/14 Inspection of Dental Radiological Equipment Form #08-4413, Revised 02/14 Miscellaneous Forms Sedation Checklist for the Dental Office Continuing Education Course Approval Application Coronal Polishing Course Approval Application Nitrous Oxide Course Approval Application Clinical Program Approval Application Division forms may be found in the CBPL Quick links, located in the sidebar to the right.